title: Feasibility and parent satisfaction of a physical therapy intervention program for children with acute lymphoblastic leukemia in the first 6 months of medical treatment.
abstract: BACKGROUND
  Children with acute lymphoblastic leukemia (ALL) are at risk for developing musculoskeletal complications during and after their medical treatment. The objective of this study was to examine the feasibility of an in-hospital physical therapy- and home exercise program during the first four phases of medical treatment, for children with newly diagnosed ALL.
  
  
  METHODS
  Nine patients, between the ages of 2-14 years old were enrolled within 2 weeks of diagnosis in the study. Each patient was evaluated at study entry, after each of the first four phases of therapy and each time patients were re-admitted to the hospital. Following the initial physical therapy evaluation an individualized home exercise program was developed, consisting of stretching, strengthening, and aerobic exercises. The following end points were measured at each evaluation: gross motor assessment as measured by gross motor function measure (GMFM), health-related quality of life as measured by the PedsQL and parent satisfaction questionnaire.
  
  
  RESULTS
  This study was feasible with 98% of the evaluation sessions completed. The GMFM and PedsQL improved steadily throughout the study; however, the PedsQL slightly decreased from interim maintenance to delayed intensification. The parents reported being satisfied with the physical therapy program.
  
  
  CONCLUSIONS
  We demonstrated that an in-hospital- and home exercise physical therapy program during the first four phases of medical treatments is feasible for children with ALL. Future randomized studies are needed to confirm whether an initial physical therapy program at diagnosis in children with ALL will limit functional impairments, improve overall fitness and increase health-related quality of life.
authors.affiliation: Department of Pediatric Hematology and Oncology, Penn State Hershey Children's Hospital, Hershey, Pennsylvania 17033, USA. sfarzingohar@hmc.psu.edu
authors.forename: Shadi Farzin
authors.initials: SF
authors.lastname: Gohar
authors.forename: Melanie
authors.initials: M
authors.lastname: Comito
authors.forename: Jennifer
authors.initials: J
authors.lastname: Price
authors.forename: Victoria
authors.initials: V
authors.lastname: Marchese
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015444:Exercise; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D010549:Personal Satisfaction; D026741:Physical Therapy Modalities; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy*; D016896:Treatment Outcome